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Insect Bites and Stings and Spider Bites

Topic Overview

Insect and spider bites often cause minor
swelling, redness, pain, and itching. These mild reactions are common and may
last from a few hours to a few days. Home treatment is often all that is needed
to relieve the symptoms of a mild reaction to
common stinging or biting insects and spiders.

Some people have more severe reactions to bites or stings. Babies and
children may be more affected by bites or stings than adults.

Examples of problems that are more serious include:

A severe allergic reaction (anaphylaxis). Severe allergic reactions are not common
but can be life-threatening and require emergency care. Signs or symptoms may
include:

Shock, which
may occur if the circulatory system cannot get enough blood to the vital
organs.

Coughing, wheezing, trouble breathing, or feeling of
fullness in the mouth or throat.

Swelling of the lips, tongue,
ears, eyelids, palms of the hands, soles of the feet, and mucous membranes
(angioedema).

A
toxic reaction to multiple stings or bites from a bee,
wasp, or fire ant.

A
bee leaves its stinger behind and then dies after
stinging. Africanized honeybees, the so-called
killer bees, are more aggressive than common honeybees
and often attack together in great numbers. Reaction to bee stings can range from minor skin swelling and redness to a serious allergic reaction.

A severe allergic reaction affects the whole body. Your doctor may have called it anaphylaxis.

Yes

History of severe allergic reaction to bite or sting

No

History of severe allergic reaction to bite or sting

Are you having any symptoms of an allergic reaction now, even mild ones?

If you've ever had a severe reaction to the same thing that's causing your symptoms now, treat this as an emergency. Mild symptoms quickly may become severe.

Yes

History of severe reaction with symptoms now

No

History of severe reaction with symptoms now

Is there any serious swelling?

This could include swelling that is not near the bite or sting area, or swelling that began at the bite or sting site but is expanding well beyond that area. (Some swelling at the site of the bite or sting is normal.)

Yes

New or expanding swelling not near bite or sting

No

New or expanding swelling not near bite or sting

Are the lips, tongue, mouth, or throat swollen?

Yes

Swelling of lips, tongue, mouth, or throat

No

Swelling of lips, tongue, mouth, or throat

Did the lips, tongue, mouth, or throat swell quickly?

Yes

Rapid swelling of lips, tongue, mouth, or throat

No

Rapid swelling of lips, tongue, mouth, or throat

Does swelling involve the palms of the hands, the soles of the feet, or the area from one large joint to another, such as from the ankle to the knee?

Yes

Swelling is across two joints, on soles of feet, or on palms of hands

No

Swelling is across two joints, on soles of feet, or on palms of hands

Is the swelling getting worse (over hours or days)?

Yes

Swelling is getting worse

No

Swelling is getting worse

Did you get an epinephrine shot, either on purpose (to treat the reaction) or by accident?

Yes

Has had epinephrine shot

No

Has had epinephrine shot

Have you been bitten or stung by a poisonous spider (such as a black widow or brown recluse spider), a scorpion, or a caterpillar?

Yes

Bitten or stung by poisonous spider, scorpion, or caterpillar

No

Bitten or stung by poisonous spider, scorpion, or caterpillar

Are there any hives?

Hives are raised, red, itchy patches of skin. They usually have red borders and pale centers. They may seem to move from place to place on the skin.

Call 911 Now

Sudden tiny red or purple spots or
sudden bruising may be early symptoms of a serious
illness or bleeding problem. There are two types.

Petechiae (say "puh-TEE-kee-eye"):

Are tiny, flat red or purple spots in the skin or
the lining of the mouth.

Do not turn white when you press on
them.

Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.

May spread over a large area of the body within a few hours.

Are different than tiny, flat red spots or birthmarks that are
present all the time.

Purpura (say "PURR-pyuh-ruh" or “PURR-puh-ruh”):

Is sudden, severe bruising that occurs for no clear
reason.

May be in one area or all over.

Is different
than the bruising that happens after you bump into something.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury.

Symptoms of shock in a child may include:

Passing out.

Being very sleepy or hard
to wake up.

Not responding when being touched or talked to.

Breathing much faster than usual.

Acting confused.
The child may not know where he or she is.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.

Long-term alcohol and drug
problems.

Steroid medicines, which may be used to treat a variety
of conditions.

Chemotherapy and radiation therapy for
cancer.

Other medicines used to treat autoimmune
disease.

Medicines taken after organ transplant.

Not
having a spleen.

You may need a tetanus shot depending
on how dirty the wound is and how long it has been since your last shot.

For a dirty wound that has
things like dirt, saliva, or feces in it, you may need a shot if:

You haven't had a tetanus shot in the past 5
years.

You don't know when your last shot was.

For a clean wound, you may
need a shot if:

You have not had a tetanus shot in the past 10
years.

You don't know when your last shot was.

Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

Passing out.

Feeling very dizzy or
lightheaded, like you may pass out.

Feeling very weak or having
trouble standing.

Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.

Pain in adults and older children

Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.

Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.

Symptoms of infection may
include:

Increased pain, swelling, warmth, or redness in or
around the area.

Red streaks leading from the area.

Pus draining from the area.

A fever.

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

Your age. Babies and older
adults tend to get sicker quicker.

Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.

Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.

Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.

Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

Try home treatment to relieve the
symptoms.

Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.

Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused,
or restless.

A severe reaction can be life-threatening. If you have had a
bad allergic reaction to a substance before and are exposed to it again, treat
any symptoms as an emergency. Even if the symptoms are mild at first, they may
quickly become very severe.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.

Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.

Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.

Home Treatment

Common bites and stings

Most bites and stings will
heal on their own without a visit to a doctor. There are several things you can
do to relieve pain and itching and prevent infection from a bite or
sting.

Insect or spider bites or stings or contact with caterpillars

Move away from the stinging or biting insect.
Bees will alert other bees, making them more likely to
sting.

Remain as calm and quiet as possible. Movement increases the
spread of venom in the bloodstream.

If you have been stung by a bee
and the stinger is still in the skin,
remove the stinger as quickly as
possible.

If you have been stung on the arm or leg, lower the limb
at the time of the sting to slow the spread of venom. Hours later, if swelling
is present, you can elevate the limb to help reduce swelling.

After
contact with a
puss caterpillar, remove broken-off spines by placing cellophane tape or
commercial facial peel over the area of the contact and pulling it off.

If you have been stung by a scorpion, see a doctor right away. There is a now a medicine (antidote) for scorpion stings.

Relieve pain, itching, and swelling

Apply an
ice pack to a bite or sting for 15 to 20 minutes once an hour for the first
6 hours. When not using ice, keep a cool, wet cloth on the bite or sting for up
to 6 hours. Always keep a cloth between your skin and the ice pack. Do not
apply ice for longer than 15 to 20 minutes at a time. Do not fall asleep
with the ice on your skin.

An
antihistamine taken by mouth, such as Benadryl or
Chlor-Trimeton, may help relieve itching, redness, and swelling. Don't give
antihistamines to your child unless you've checked with the doctor first.

A spray of
local anesthetic containing benzocaine, such as Solarcaine, may help relieve
pain. If your skin reacts to the spray, stop using it.

Hydrocortisone 1% cream or calamine lotion applied to the skin may help relieve itching
and redness. Note: Do not use the cream on children
younger than age 2 unless your doctor tells you to. Do not use in the rectal or
vaginal area in children younger than age 12 unless your doctor tells you to.

After the first 6 hours, if swelling is not
present, try applying warmth to the site for comfort.

Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin

Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow
these safety tips when you use a nonprescription medicine:

Carefully read and follow all
directions on the medicine bottle and box.

Consider a
home remedy, such as putting witch hazel or underarm deodorant on the bite. Home remedies haven't been proven
scientifically, but usually they won't hurt you if you want to try them.

Prevent a skin infection

Wash the area with soap and
water.

After washing, wipe the area with rubbing alcohol or
first-aid antiseptic.

Trim fingernails to prevent scratching, which
can lead to infection.

Do not break any blisters that
develop.

If a bite becomes irritated, apply an antibiotic ointment,
such as bacitracin or polymyxin B sulfate, and cover it with an adhesive
bandage. The ointment will keep the bite from sticking to the bandage.
Note: Stop using the ointment if the skin under the
bandage begins to itch or a rash develops. The ointment may be causing a skin
reaction.

Symptoms to watch for during home treatment

Prevention

Take the following measures to help
prevent bites and stings.

Apply
insect repellent before going into the woods or other
areas where you may come in contact with insects. Use insect repellents
according to directions, particularly when applying repellent to
children.

Apply repellents safely.

Use a lower-concentration repellent on
children.

Do not put repellent on small children's hands, since
they often put their hands in their mouths.

Wash the insect
repellent off with soap and water after returning indoors.

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